| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $90.30 | $97.45 | $103.71 | |
Cigna
| Facility | $105.05 | $105.05 | $105.05 | |
Cigna
| Professional | $89.41 | $105.05 | $105.05 | |
Providence
| Facility | $89.41 | $105.05 | $108.98 | |
Providence
| Professional | $97.00 | $97.00 | $126.52 | |
United
| Professional | $89.41 | $89.41 | $89.41 |